1. Support the growth and development of a Risk Factor Research program at MMC with a focus on elimination of health disparities. Meharry Medical College has had a long history of conducting basic science and clinical research, but because of the faculty make-up (basic scientists and clinicians) it has smaller cadre of faculty interested in health services research. The research infrastructure was not sufficient to support population-based, social/.behavioral, outcomes or health services research. Funding of the Meharry EXPORT Center has enabled MMC to recruit senior core faculty, develop the infrastructure to support population-based, social/behavioral, outcomes, and health services research. This was accomplished by creating institutional support for health services research and breaking down departmental barriers to collaboration. Recruitment and hiring of senior health services research scientists, identifying new partners for collaboration at Tennessee State University and Vanderbilt University, and securing a common space and funds to remodel and refurbish the area were achievements of the leadership of the Center. In August 2004, Dr. Juarez became the program director of the EXPORT Center. At that time, the Center had just received funding. The Center did not have senior health services research investigators at Meharry. There was not an epidemiologist or statistician and the only research oriented behavioral scientist had just accepted a position at another institution. Dr. Juarez met with the Dean/Pi and together, they developed a plan to recruit new faculty. The Dean pulled all of the institutional research centers together and found out that many of the Centers had part time positions for social and behavioral scientists, epidemiologists, and statisticians in their budgets, including EXPORT, but were unable to fill the positions. The Dean was able to get Center directors to pool support of these part-time positions so that recruit fulltime faculty could occur. Dr. Juarez chaired a national search committee to recruit a senior epidemiologist, statistician, and social/behavioral scientist. At the conclusion of the search, Drs. Maureen Sanderson and Vincent Agboto were hired. In addition, Dr. Juarez was able to attract Dr. Robert Levine, a very experienced public health investigator, back to Meharry. While we were unsuccessful in attracting a senior social/behavioral scientist, we were able to recruit two junior social/behavioral faculty members: Marino Bruce, PhD, Sociologist and Vanessa Elliott, PhD, Psychologist. Dr. Bruce was successful in obtaining funding for a K-award on his first attempt. Another national search for a senior social behavioral scientist in the next few months will be underway. In a very short time, we have recruited an exceptional strong nucleus of senior and junior social/behavioral and health service researchers who are poised to lead us to the next level. 2. Strengthen collaborations between MMC and VU. In the original application, we were partnered with the Center for Health Services Research at Vanderbilt University Medical Center (VUMC). While the relationship did lead to pairing of junior investigators at MMC with senior research mentors at VUMC, the relationship did little to increase scholarly productivity. Over the four years, there were only a small number of publications and grants that came out of the formal collaboration and none that acknowledged the EXPORT Center. During this period, Dr. Juarez began working with social and behavioral scientists at both Vanderbilt University, mostly outside of the Medical Center as well as with investigators at TSU. These relationships have turned out to be very productive and mutually beneficial in generating collaborative research, publications, and research training activities. So while, the initial intent of developing a collaborative relationship with the Center for Health Services Research at VUMC did not pan out, we have developed strong collaborative relationships with a group of both junior and senior investigators at both Vanderbilt University and at Tennessee State University, across a broad spectrum of disciplines, who we will work with in this new application. The willingness of the large group of investigators at both TSU and VU who want to work with our "EXPORT" faculty, and are willing to do so without compensation, is a testament to the strength of the collaborative relationships we have established. 3. Strengthen the research infrastructure at MMC. We have strengthened the research infrastructure tremendously at MMC over the past four years in a number of ways, evidenced by the increase in scholarly productivity. The infrastructure has been strengthened through the hiring of new faculty who we have been able to recruit and through the collaborative relationships we have established with investigators at both TSU and Vanderbilt University. In addition to having a core nucleus of senior investigators, we also now have a defined space and identification for continuing the work of the EXPORT Center under this new initiative. During the initial funding period, the EXPORT Center has helped the institution strengthen its research infrastructure in way that supports health services research at MMC. We purchased the initial institutional site licenses for both SPSS and SAS, which the institution now fully supports because of the demand by faculty and graduate students that were generated when the EXPORT Center no longer supported the institutional licenses. In addition, we have worked closely with our College's Office of Information Technology (OIT) to support growth in institutional capacity to store, manage, and analyze large data sets. The OIT has recently (April 2008) hired a fulltime, mid-level, data manager to work with researchers. The inclusion of secondary data analysis in this new application will allow for the strengthening of capacity for managing, storing, and analyzing large secondary data sets. This is critical in supporting our work in health disparities, but also for training of junior investigators. Secondary data sets offer junior investigators opportunities for carrying out research and getting published quickly and in peer reviewed journals. This is particularly important for our clinical faculty who often do not have the level of protected time needed to conduct prospective studies. A faculty level person trained in informatics has been recruited. This will add tremendously to the capacity, which is necessary. The Office of Faculty Development and Affairs has also become increasingly involved in supporting the EXPORT Center. The Associate VP for Faculty Affairs and Development now regularly conducts faculty development sessions on health services research topics and supports faculty in going to professional conferences and training seminars to enhance their skills. 4. Increase scholarly productivity. Changes in the level of scholarly and core activities are identified in Figure 1. Scholarly activities are defined as numbers of research and other grants funded, number of papers published in peer reviewed journals, number of abstracts published, professional presentations given, training activities provided, and community education and outreach activities conducted. Only activities of nine core faculty supported by the EXPORT Center are included. A detailed list of all categories is included in the attached CD.